Short Version Bls -Cpr 2012 (Infant&Child) Outline

7/23/2019 Short Version Bls -Cpr 2012 (Infant&Child) Outline

http://slidepdf.com/reader/full/short-version-bls-cpr-2012-infantchild-outline 1/157

http://circ.ahajournals.org/content/vol122/18_suppl_3/



FACTS

• Children < 1yr –Falls & burns @ home

• 1-4 yrs old – Inhale or ingest foreign bodies

• 5- yrs old –Traffi! & s!hool a!!ident

• "-#$ years old –%i!tim of hysi!al assult



'( )ATT*+ ,AT T* CA.S*///

• ,hen the heart has stoed andthe 0i!tim is not breathing C2+is the ans3er

• ,ithout a !onstant suly of

blood !ells of the body3ill start to die



NO MATTER WHAT THE CAUSE………

• rain damage begins 3ithin 4 to6 minutes after !ardia! arrest

• ,ithin " to 1$ minutes thedamage may be irre0ersible



Clinical Death

$-1 min 7 Cardia! Irritability 1-4 min - rain damage - not li8ely

4-6 min - rain damage - ossible

Biological Death

6-1$ min 7 rain damage - 0ery li8ely(0er 1$ min7 Irre0ersible brain

damage



'( )ATT*+ ,AT T* CA.S*///

• Cardioulmonary resus!itation

3ill hel to !ir!ulate o9ygenatedblood until more ad0an!edmedi!al !are !an be erformed



Why the need for CPR training?

• )ost eole die of heart atta!8before they e0er rea!h a

hosital• (ther situations !an lead to C2

arrest

CP arrest can occuranytime & anywhere



Emergency Action Principe !

2lan of a!tion for anyemergen!y to ensure theres!uer:s safety and that of the0i!tim and bystanders and

in!rease the 0i!tim:s !han!esof sur0i0al



Emergency Action Principe

1 Sur0ey the S!ene

# A!ti0ate medi!al assistan!e

; Initial assessment of the 0i!tim4 Se!ondary assessment of the

0i!tim

5 +eferral for further e0aluation andmanagement



1 Sur0ey the S!ene

)a8e sure that the s!ene of theemergen!y is safe for you the 0i!timand the bystanders

!onsider - S!ene safety

- )e!hanism of in=ury or nature of

illness - >etermine the number of ersons ?

0i!tim and additional resour!es



"# Acti$ate Medica

A%%i%tance• Call First “ : If adult reuires

emergen!y !are

• Care First” : for infant and

!hild



Information to be gi0en in a!ti0itingmedi!al assistan!e

• ,hat haened B

• o!ation B

•

'umber of ersons in=uredB• *9tent of in=ury and First Aid gi0enB

• The telehone number from 3here youare !alling?

• Identity of the erson !alling

• Drop the phone last



; >o rimary sur0eyof 0i!tim

• Che!8 resonsi0eness

• 2erform !omression

• 2erform res!ue breathing• (en the Air3ay



4 >o Se!ondary Assessment of the %i!tim

• A systemati! method of gatheringadditional information about in=uries or!onditions that may need !are

a Inter0ie3 the %i!tim DSA)2*E b Che!8 0ital signs e0ery 15 minutes

if stable !ondition and e0ery 5

minutes if unstable

! ead to toe e9amination

D>CA2TSE



4 a Inter0ie3 the 0i!tim

S – signs and symptoms A - Allergies

M - )edi!ines

P – Past Medical History

L - Last oral intake

E - events prior to injury,

incident or illness



4! ead to toe e9amination

D : Deformity

C : Contusion

A : Abrasions P : Puncture

B : Burn

T : TendernessL : Laceration

S : Swelling



5 +eferral of %i!tim for further

*0aluation and )anagement

• refers to the transfer of a

0i!tim to hosital or health!are fa!ility for a definiti0etreatment



ody Substan!e Isolation

Are re!autions ta8en to isolateor re0ent ris8 of e9osure from

any other tye of bodilysubstan!e using ersonalrote!ti0e euiment D22*E



asi! 2re!autions & 2ra!ti!es

• 1 2ersonal ygiene

# 2rote!ti0e *uiments

; *uiments for !leaningand disinfe!ting



olden +ules in i0ing *C

D ! S : Do obtain consent wen possible

Do tink o! te worst

Do remember to identi!y yoursel!

Do provide com!ort and emotional

support Do respect te victim

"modesty and privacy#



>( G S

&o 'e a% cam and direct a%po%%i'e

&o care for the mo%t %erio(%in)(rie% *r%t

&o a%%i%t the $ictim on medication

&o +eep on oo+er% a,ay from thein)(red per%on

&o hande the $ictim to theminim(m

&o oo%en tight cothing



>(':Ts •

>o not let the 0i!tim see his ?her in=uries

• >o not lea0e the 0i!tim alone

e9!et to get hel• >o not assume that the 0i!tim:s

ob0ious in=uries are the only one

• >o not ma8e any unrealisti! romises

• >o not trust the =udgment of

a !onfused erson



-ife S(pport

• The cardiop(monaryre%(%citation ! %erie% of

emergency ife %a$ingproced(re% that are carried o(tto proong the ife of a per%on

,ith ife threateningemergencie%



Type%.%tage% of ife %(pport

1 asi! ife Suort DSE

# Ad0an!ed Cardia! ife Suort

DACSE

; 2rolonged ife Suort

D2SE



Stage of -ife S(pport

1. Basic Life Support

- an emergen!y ro!edure that!onsists of re!ogniHing resiratoryor !ardia! arrest or both and theroer ali!ation of C2+ tomaintain life until a 0i!tim re!o0ers

or ad0an!ed life

suort is a0ailable



Stage% of -ife S(pport

1. Basic Life Support

a. CAB Stes

Comression D!ir!ulationE

Air3ay

Breathing D0entilationE

b .se of sulementary

te!hniues




2. Advanced cardiac Life Support(ACLS)

/ The (%e of %pecia e0(ipment tomaintain 'reathing.circ(ation for the$ictim of cardiac emergency#

/ A %et of cinica inter$ention% for the

(rgent treatment of cardiac arre%t

and other ife threateningemergencie% and the

1 2 S to depoy tho%e inter$ention%




a# Denitive therapy 3 dr(g%4de*'riation

'# Cardiac monitoring %ta'ii5ationc# Tran%portation

d# Comm(nication



Stage of -ife S(pport

6# Prolonged Life Support(PLS)

- 7or po%t re%(%citati$e and ongterm re%(%citation ,ith the (%e ofad)(ncti$e e0(ipment %(ch a%$entiator4 cardiac monitor4 p(%e

o8imeter4 etc#



9a%ic -ife S(pport

• the "oun#ation !or saving

lives !ollowing cardiac

arrest$



7(ndamenta A%pect% of 9-S !

:mmediate recognition of %(ddencardiac arre%t ;SCA< and acti$ation

of emergency re%pon%e %y%tem Eary cardiop(monary

re%(%citation ;CPR<

Rapid de*'riation ,itha(tomated e8terna de*'riator;AE&<



Cardiop(monaryRe%(%citation ;CPR<

• An emergency procedure usedfor a person who is not breathing

and whose heart has stoppedbreathing ( cardiac arrest



Cardiop(monary Re%(%citation ;CPR<• !s a series of assessments and

inter"entions using techni#ues andmaneu"ers made to bring "ictims of

cardiac and respiratory arrest bac$to life%



When to Start CPR

• CPR %ho(d 'e %tarted on a non/'reathing4 p(%ee%% patient%4 (ne%%

they are o'$io(%y dead or ha$e a&NR order#

;Re%ponder% ,i need to %ee a $aidcopy of the order to honor it#<



When to Start CPR

• :t i% 'etter to %tart CPR on a per%onthat i% ater decared dead 'y a

phy%ician than to ,ithhod CPR from%omeone that co(d ha$e 'een %a$ed#

hen in Dou!t"#e$u$citate%



Criteria for not %tarting CPR

• All patient$ in cardiac arre$t receivere$u$citation unle$$&

=#The patient ha% a $aid > &o notRe%(%citate >

; &NR< order

"# Patient ha% %ign% of :rre$er%i'e &eath;rigor morti%4 decapitation4 or dependenti$idity4

decompo%ition<



Sign% of &eath

Decapitation The head is

searated from the rest of the

body

Rigor mortis Temorary

stiffening of mus!les o!!urs

se0eral hours after death



Sign% of &eath

'vidence of ti$$ue decopo$ition !Act(a

e%h decay occ(r% ony after a per%on ha%'een dead for more than one day#

Dependent lividity ! Red or p(rpecoor

occ(r% on the part% of the patient@% 'ody

that are co%e%t to the gro(nd#



Criteria for not %tarting CPR

6# No Phy%ioogica 'ene*t can 'e e8pected'eca(%e $ita f(nction% ha$e deterioratedde%pite ma8ima therapy eg# Progre%%i$e%hoc+ or cardiogenic %hoc+

# Withhoding attempt% to re%(%citate inthe dei$ery room i% appropriate forne,y 'orn infant% ,ith!

– Con&rm gestation ') weee$s or birthweight '*++g

– Anencephaly

– Confrimed trisomy ,) or ,-%

B# Attempt% to perform CPR ,o(d pace there%c(er at



When to %top CPR

S pontaneo(% 'reathing and p(%eha% 'een re%tored

(rned o$er to profe%%iona hep* perator. Re%c(er i% too e8ha(%ted

to contin(e

P hy%ician A%%(me% re%pon%i'iityS cene 'ecome% (n%afe

S igned ,ai$er to %top CPR



S(mmary of 1ey :%%(e% andMa)or Change%

#

Key issues and major changes in the 2010

AHA Guidelines for CPR and ECCrecommendations for healthcare proiders

include the follo!ing"




• Cardiac arre%t $ictim% may pre%ent,ith a %hort period of %ei5(re/i+e

acti$ity or agona ga%p% that mayconf(%e potentia re%c(er%4di%patcher% %ho(d 'e %peci*cay

trained to identify the%e pre%entation%of cardiac arre%t to impro$e cardiacarre%t recognition#




• The heathcare pro$ider 'riey chec+% forno 'reathing or no norma 'reathing ;ie4 no

'reathing or ony ga%ping< ,hen thepro$ider chec+% re%pon%i$ene%%#

• The pro$ider then acti$ate% the emergency

re%pon%e %y%tem and retrie$e% the AE& ;or %end% %omeone to do %o<#




The heathcare pro$ider %ho(d not %pendmore

than = %econd% chec+ing for a p(%e4 and ifa

p(%e i% not de*nitey fet ,ithin =

%econd%4%ho(d 'egin CPR and (%e the AE& ,hen

a$aia'e#

f d




• >-oo+4 i%ten4 and fee for'reathingD ha% 'een remo$edfrom the agorithm#

S f 1 : d




• U%e of cricoid pre%%(re d(ring$entiation% i% generay notrecommended#

• Se0(ence change to che%tcompre%%ion% 'efore gi$ing re%c(e

'reath% ;C/A/9 rather than A/9/C<#



S(mmary of 1ey :%%(e% and Ma)orChange%

:ncrea%ed empha%i% ha% 'een paced on high/

0(aity CPR ;Parameter% of eFecti$e4 high0(aity CPR<

=# Compre%%ion% of ade0(ate rate at ea%t =.min"# Compre%%ion depth of at ea%t =.6 AP diameter

or

" inche%;B cm<

6# Ao,ing compete che%t recoi 'et,eencompre%%ion%

# Minimi5ing interr(ption% in compre%%ion%4

B# A$oiding e8ce%%i$e $entiation

S f 1 : d




• eginning C2+ 3ith ;$!omressions rather than #

0entilations leads to a shorterdelay to first !omression

S f 1 : d




• Comression rate is modifiedto at least 1$$?min from

approximately 1$$?min



Ne, Se0(ence

+' *LD #A,*+AL'



9-S CHANGES Che%tcompre%%ion%4

Air,ay4 9reathing ;C/A/9<Ne, %cienceindicate% the

foo,ing order!=# Chec+ thepatient forre%pon%i$ene%%and no 'reathing#

"# Ca for hepand get the AE&6# Chec+ thep(%e#

# Gi$e 6com %#

Air,ay4 9reathing4Che%t

compre%%ion%;A/9/C<

Pre$io(%y4 afterre%pon%i$ene%%

,a% a%%e%%ed4 aca for hep ,a%made4 the air,ay,a% opened4 the

patient ,a%

chec+ed for'reathing4 and "

'reath% ,eregi$en4 foo,ed 'y

a p(%e chec+ andcom re%%ion%

Atho(gh$entiation% are an

important part ofre%(%citation4

e$idence %ho,%that compre%%ion%

are the criticaeement in ad(tre%(%citation#

:n the A/9/C

%e0(ence4compre%%ion% areoften deayed 'y

changing the

%e0(ence to C/A/9 re%c(er% can

+' *LD #A,*+AL'



9-S CHANGES Compre%%ion%%ho(d 'e

initiated ,ithin= %econd% ofrecognition of

the arre%t#

Compre%%ion%,ere to 'e

gi$en afterair,ay and'reathing ,ere

a%%e%%ed4

$entiation%,ere gi$en4 andp(%e% ,erechec+ed#

Atho(gh$entiation% are

an importantpart ofre%(%citation4

e$idence %ho,%

thatcompre%%ion%are the critica

eement in

ad(tre%(%citation#Compre%%ion%

are often

deayed ,hie

+' *LD #A,*+AL'



9-S CHANGES

Compre%%ion%%ho(d 'egi$en at a

rate ofat lea$t =.min#

Each %et of6

compre%%ion%

%ho(d ta+e

Compre%%ion%,ere to 'egi$en at a

rate ofa!out=.min#

Each cyce of6

compre%%ion%

,a% to 'e

7a%ter

compre%%ion%are re0(iredto generate

the pre%%(re%nece%%ary toperf(%e the

coronary and

cere'raarterie%#

+' *LD #A,*+AL'



9-S CHANGES Compre%%iondepth% are a%

foo,%! Ad(t%! atlea$t " inche%;B cm<

Chidren! atea%t =.6 thedepth of theche%t4

appro8imatey "inche% ;B cm< :nfant%! atea%t =.6 the

depth of the

Compre%%iondepth% ,ere a%

foo,%! Ad(t%! =J to" inche% Chidren! one

third to onehaf thediameter of theche%t

:nfant%! onethird to onehaf thediameter of the

che%t

&eepercompre%%ion%

are re0(ired togenerate thepre%%(re%nece%%ary to

perf(%e thecoronary andcere'raarterie%#



Rationae 7or Change

• High/0(aity che%t compre%%ion%,ithin CPR contin(e% to 'e a criticafoca point#

• We/performed compre%%ion%increa%e the i+eihood of %(r$i$a#

Chid.:nfant Compre%%ion



Chid.:nfant Compre%%ionRate

#Push fast$ push at a rate of

at least 100 compressions per minute%&

'(erg) et al% Circulation%

2010$122$*+,2-*+./

2010 Guidelines



Rationae 7or Change

• :t ha% 'een fo(nd that higher%(r$i$a rate% are a%%ociated ,ithan increa%e in the n(m'er ofcompre%%ion% pro$ided permin(te#



Chid.:nfant Compre%%ion &epth

Chest !omressions of aroriaterate and deth G2ush fast: ush ata rate of at least 1$$ !omressions

er minute G2ush hard: ush 3ithsuffi!ient for!e to deress at leastone third the anterior-osterior DA2Ediameter of the !hest oraro9imately 1 in!hes D4 !mE ininfants and # in!hes D5 !mE in!hildrenJ '(erg) et al% Circulation. 2010$122$*+,2-

*+./

2010 Guidelines



9reathing A%%e%%ment

After a!ti0ation of the emergen!yresonse system all res!uers shouldimmediately begin C2+ for adult 0i!tims3ho are unresonsi0e 3ith no breathing orno normal breathing Donly gasingEJ

'(erg) et al% Circulation. 2010$122$*,+/-*.0/

2010 Guidelines



Highight%

• No more oo+4 i%ten4 and fee#

• K(ic+ >oo+D for no 'reathing or nonorma 'reathing#

• Agona 'reath% remain a concern#

• Appie% to 'oth ay and heathcarepro$ider%#

CPR S HCP



CPR Se0(ence / HCP

or an unresponsie person !ho is not reathing or

not reathing normally) and has no oious pulse)

actiate E3* and egin CPR !ith 40 compressions

follo!ed y opening the air!ay and giing 2

rescue reaths% Repeat cycles of 40"2 'CA(

method%

'*ummary from (erg) et al% Circulation.

2010$122$*,+/-*.0/

2010 Guidelines



Highight%

• :nitia a%%e%%ment approach! – A%%e%% re%pon%i$ene%% and 'reathing – Acti$ate EMS – A%%e%% p(%e – Perform CPR

•

CA9 3 'egin CPR cyce% ,ithcompre%%ion%4 foo,ed 'y air,ay and'reathing#



Rationae 7or Change

• The %cience indicate% the importanceof not deaying che%t compre%%ion%to perform re%c(e 'reath%#

• Eary che%t compre%%ion canimmediatey circ(ate o8ygen that i%

%ti in the 'ood%tream#



Respiratory Arrest

and

• Rescue Breathing

Re%piratory Emergency and



Re%piratory Emergency andArti*cia Re%piration

#e$piratory arre$t

3 A condition in ,hich 'reathing

%top% or inade0(ate4 p(%ecirc(ation contin(e for %ometime

Eary Warning %ign% of Re%piratory



Eary Warning %ign% of Re%piratoryArre%t

• Una'e to %pea+4 'reathe or

co(gh• Clutche$ nec (universal

distress signal)

• 9(i%h coor of %+in 2 ip%



Cau$e$ of #e$piratory Arre$t

=# *!$truction=#= Anatomica ! ,hen tong(e drop% 'ac+

and o'%tr(ct the throat# Other ca(%e% areac(te a%thma4 diphtheria4 %,eing and

co(gh

=#" Mechanica ! ,hen foreign o')ect%

odge in pharyn8 or air,ay%L (idacc(m(ate% in the 'ac+ of the throat#



Cau$e$ of #e$piratory

Arre$t

2. Di$ea$e$

• 9ronchiti%• Pne(monia

• COP& and other re%piratory ine%%

C f # i t



Cau$e$ of #e$piratoryArre$t

. *ther cau$e$

Eectroc(tionCirc(atory Coap%eStrang(ationChe%t Compre%%ion

&ro,ningPoi%oningEpiep%y 4 Aergy

S(Focation or Smo+e inhaation



Articial #e$piration

(#e$cue Breathing)

/ proced(re of ca(%ing air to o, intoand o(t of the (ng% ,hen hi% nat(ra'reathing cea%ed or i% inade0(ate

/ techni0(e of 'reathing air into aper%on@% (ng% to %(ppy him theo8ygen needed to %(r$i$e

Arti*cia Re%piration



p ;Re%c(e 9reathing<

• Gi$en to a $ictim ,ho are not'reathing or inade0(ate '(t %tiha$e p(%e#

• Cr(cia too to re$i$e the indi$id(aor +eep him.her (nti hep come%



*!/ective$ of A#

=#To open air,ay ! head tit.chin

ift method"#To $entiate the (ng%# To re%tore'reathing

Way% to $entiate the (ng%




0. 1outh to outh !reathing& Thi% in$o$e% the re%c(er ma+ing

a %ea 'et,een their mo(th andthe patient@% mo(th and 'o,ing4to pa%% air into the patient@% 'ody





"# 1outh to no$e !reathing& :n%ome in%tance%4 the re%c(er may

need or ,i%h to form a %ea ,iththe patient@% no%e





6# 1outh to outh and no$e

!reathing! U%ed in infant%; (%(ay

(p to aro(nd = year od<4 a% thi%form%

the mo%t eFecti$e %ea





. 1outh to $toa !reathing!U%ed

,hen the mo(th and the no%e

i% inacce%%i'e#

/ U%(ay (%ed in ad(t%





B# 1outh to face $hield !reathing!

:n$ention reate% to a de$ice for

performing ife %a$ing mo(th tomo(th

re%piration ,itho(t the operatordirecty

to(ching the mo(th of the patient




# 1outh to a$ !reathing& Mo%t organi5ation% recommend

the (%e of %ome %ort of 'arrier'et,een re%c(er and patient tored(ce cro%% infection ri%+# One

pop(ar type i% the poc+et ma%+




.Bag valve a$ device & A%impe

de$ice man(ay operated 'y there%c(er4 ,hich in$o$e%%0(ee5ing a 'ag to e8pe air into

the patient



Specia Con%ideration% !

• Re%c(er to a$oid pre%%ing %oft ti%%(e(nder the chin thi% might o'%tr(ctthe air,ay#

• Re%c(er not to (%e the th(m' to iftthe chin

• Re%c(er not to co%e the $ictim@%

mo(th competey ;(ne%% mo(th tono%e i% the techni0(e<

i id i




• Each re%c(e 'reath %ho(d gi$eeno(gh air to ma+e the che%t ri%eand 'e gi$en at = %econd#

• Re%c(er %ho(d a$oid dei$eringmore 'reath% ;more than the n(m'errecommended< or 'reath% that are

too arge or too forcef(#

S i C id i




• Re%c(er% %ho(d ta+e a norma'reath ;not a deep 'reath< mo(th tomo(th or mo(th/to/'arrier de$ice

re%c(e 'reath% #

H d Ti Chi -if M h d



Head Tit Chin -ift Method

=# 1nee near the ca%(aty@% %ho(der%

"# Pace one of yo(r hand% on theca%(aty@% forehead and appy *rm4'ac+,ard pre%%(re ,ith yo(r pam

to tit the ca%(aty@% head 'ac+#



H d Tit Chi -ift M th d




6# Pace the *ngertip% of yo(r otherhand (nder the tip of the 'ony part

of the ca%(aty@% o,er )a, and iftthe )a, to 'ring the chin for,ard#

The &ngertips should not press deeply intothe soft tissues under the chin since the pressure

could !t interfere with the casualty.s airway%

/se your &ngertips0 not your thumb0 to lift the chin%



H d Tit Chi -ift M th d




# -ift the chin for,ard (nti the (pper and

o,er teeth are amo%t 'ro(ght together#

The mouth should not be closed as this may bloc$ theairway%

!f needed0 the thumb may be used to

depress the casualty.s lower lip slightlyto $eep his mouth open%

a, Thr(%t Method



a (% e od

=# 1nee 'ehind the ca%(aty@% headand re%t yo(r e'o,% on the

%(rface on ,hich the ca%(aty i%ying#



a, Thr(%t Method



"# Pace one hand on each %ide of theca%(aty@% head and gra%p the

ange% of the o,er )a, )(%t 'eo,the e$e of the teeth



a, Thr(%t Method



6# -ift ,ith 'oth hand% to mo$e the )a,for,ard# Thi% action ,i a%o ca(%ethe ca%(aty@% head to tit 'ac+#

$eep the head and nec$ from mo"ing more than

necessary%

!f mouth to mouth resuscitation0 e1orts are

not e1ecti"e0 you may need to increase the

bac$ward tilt of the head slightly

a, Thr(%t Method



# :f the ca%(aty@% ip% are %ti co%edafter the )a, ha% 'een mo$ed

for,ard4 (%e yo(r th(m'% to retractthe o,er ip and ao, air to enter theca%(aty@% mo(th#

Cardiac Emergency and CPR



Cardiac Emergency and CPR

Cardiac arre$t

/ Circ(ation %top%L p(%e and

'reathing %top% at the %ame timeor %oon thereafter

N i A t



N(r%ing Aert

There are ony minor diFerence% in re%c(e'reathing for ad(t%4 chidren and infant%#

Often4 the oder the $ictim the greater the headtit to hep open the air,ay

Adult Child ,nfant*pening of 1a i tilt of +e tral pl $ +e tral po$ition



*pening ofair3ay (headtilt chin lift

aneuver

1a4iu tilt ofthe head

+eutral plu$ +eutral po$ition

Location forchecing of

pul$e

Carotid pul$e Carotid pul$e Brachial pul$e

1ethod 1outh to outhor outh to

no$e

1outh to outhor outh to

no$e

1outh to outhand no$e

Breath$ 5ull" $lo3!reath (0.6 to 2

$econd$ per!reath)

5ull" $lo3regulated

!reath (0 to 0.6

$econd$ per!reath)

7entle " $lo3!reath

(0 to 0.6$econd$ per

!reath)

A#ventilation8$eco

nd$( 2 in frae)

0& 6(29 cycle$)

0 & ( 9: cycle$ )

0 & ( 9: cycle$ )



A:RWA AN& 9REATH:NG

9-S CHANGES+' *LD #A,*+AL'

Cricoid :f an Randomi5ed



9-S CHANGESCricoidpre%%(re i%

no ongerro(tineyrecommended for (%e ,ith$entiation%#

:f anade0(ate

n(m'er ofre%c(er% ,a%a$aia'e4one co(dappy cricoidpre%%(re#

Randomi5ed%t(die% ha$e

demon%tratedthat cricoidpre%%(re %tiao,% fora%piration#

:t i% a%o

dic(t topropery trainpro$ider% to

perform the

9-S CHANGES+' *LD #A,*+AL'

>-oo+4 i%ten4 and >-oo+4 With the ne, che%t



9-S CHANGESfee for 'reathingDha% 'een reoved

from the %e0(encefor a%%e%%ment of'reathing afteropening the air,ay#

Heathcare pro$ider%'riey chec+ for'reathing ,henchec+ing

re%pon%i$ene%% todetect %ign% ofcardiac arre%t#

After dei$ery of 6com % one re%c(er%

i%ten4 andfee for

'reathingD,a% (%ed toa%%e%%'reathingafter theair,ay ,a%opened#

comp%3*r%t%e0(ence4 CPR i%

performed if the ad(t$ictim i%(nre%pon%i$e and not'reathing or not'reathing normay; ony ga%ping< and'egin% ,ith comp%;CA9<

Therefore4 'reathingi% 'riey chec+ed a%part of a chec+ forcardiac arre%t#

After the *r%t %et of

Reco$ery Po%ition



Reco$ery Po%ition

:f the $ictim i% (ncon%cio(% '(t 'reathing!

– Ro the patient onto one %ide4 a% yo(

%(pport the patient@% head#

– Pace the patient@% face on hi% or her %ide

%o any %ecretion% drain o(t of the mo(thand the

tong(e ,on@t 'oc+ the air,ay#

Reco$ery Po%ition



Reco$ery Po%ition• Adult and !hild

end Arm Kee legs straight

2la!e ba!8 of 0i!tim:s hand

against !hee8 and hold there

old 0i!tim:s hand against his

!hee8 to suort head

2ull bent leg and roll 0i!tim

to3ard you



Reco$ery Po%ition in CPR

ands suorts head

bent 8nee re0ents rolling

ent arms gi0es stability

Po%%i'e Compication%




Broen ri!$ Chec+ hand pacement andcontin(e





7a$tric Di$ten$ion (air in the$toach)Can happen if the air,ay i% not open4 re/

tit headMa+e %(re 'reath% are not gi$en too

forcef(y or too fa%t4 gi$e in = %econd eachand ao, for e8haation

Gi$e 'reath% ony (nti the che%t ri%e%9e aert for $omiting and +eep air,ay cear





Che$t doe$ not ri$eRepo%ition head and try 'reathagain# :f it@% %ti not ri%ing go right

to compre%%ion%





<icti !reathe$ through a $toa(opening in the nec)

:f the che%t doe% not ri%e ,ith'reath%4 co$er mo(th and no%e forpo%%i'e air ea+age



:mportant Con%ideration%

AD;L C=,LD ,+5A+*pening the 1a4iu tilt +eutral +eutral



Air3ay of the head po$ition po$ition

Location of

opre$$ion

Center of the

che$t

Center of the

che$t

*ne (,)

nger 3idth!elo3 the

nipple line

1anner of

opre$$ion

=eel of the

hand" other

hand on top

=eel of the

hand

( 1 handdepending on the

size o the child )

5inger$ (!iddle and ring

"ngertips)

Depth che$t

copre$$ion

2 inche$ (6

c)

2 inche$ (6

c)

0 > inche$

(9c)

# ratio of che$tpre$$ion to

entilation$

2 in frae )

:&2( 6 cycle$) :&2( 6 cycle$) :&2( 6 cycle$)

P# counting 0"2""9"6"?""@""0:"00"02"0"09"06"0?"0"0@"0

"2:"0"2""9"6"?""@" and 0 (2 ventilation$) up



Se0(ence



2oreign Body Airway

3bstruction 4anagement

"%&A'#

7 i 9 d Ai O' t ti



7oreign 9ody Air,ay O'%tr(ction

;79AO< a !ondition 3hen solid material

li8e !hun8ed foods !oins0omitus small toys et! areblo!8ing the air3ay

Ca(%e% of Air,ay O'%tr(ction




1 Imroer !he3ing of largeie!es of food

# *9!essi0e Al!ohol Inta8e

a +ela9ation of the tongue ba!8

into the throat

b Asirated 0omitus

Dstoma!h !ontentE




y

; The resen!e of loose uer andlo3er dentures

4 For older !hildren 3ho arerunning 3hile eating

5 For smaller !hildren of hand to

mouth stage left unattended

7oreign 9ody Air,ay O'%tr(ctionM t



Management

3o ype$ of *!$truction

=# Anatomica

"# Mechanica

T T f O' t ti



T,o Type% of O'%tr(ction

$% Anatomical struction Happens wen te tongue drops

back and obstructs te troat$

'ter causes are acute astma,croup, dipteria, swelling

and coug "wooping#

T,o Type% of O'%tr(ction



yp

'% Mechanical struction (en !oreign objects lodge in te

paryn) or airways* !luids

accumulate in te back in tetroat$

7oreign 9ody Air,ay O'%tr(ctionManagement



Management

Cla$$ication of*!$truction

1 )ild# Se0ere

Ca%%i*cation of O'%tr(ction




$% Mil# struction

A% Si(ns

+$ ood air e)cange

$ .esponsive and can coug!orce!ully

/$ May wee0e between coug

1$ Has increased respiratory

di!!iculty$

= Mid O'%tr(ction



=# Mid O'%tr(ction

)% *escuer Actions

As long as good air e)cangecontinues$

a$ 2ourage te victim to continue

spontaneous couging and breating e!!orts

b$ Do not inter!ere wit te victim3s

own attempts to e)pel te !oreign

body, but stay wit im and

monitor is condition$





'% Se+ere struction A% Si(ns

+$ Poor or no air e)cange

$ (eak or ine!!ective coug or no coug at all$

/$ Hig-pitced noise wile

inaling or no noise at all$

1$ 4ncrease respiratory di!!iculty

# Se0ere (bstru!tion



# Se0ere (bstru!tion A Signs

5$ 2yanotic 6$ 7nable to speak

8$ 2lutcing te neck wit te tumb

and !ingers making te universalsign o! coking

9$ Movement o! air is absent$



Are yo( cho+ing?



Are yo( cho+ing?

1ild *!$tructionictim i% a'e to co(gh

or i% gagging

ictim i% a'e to %pea+and 'reath

Enco(rage $ictim toco(gh and monitorthem in ca%e the air,ay

'ecome% 'oc+ed

Severe *!$tructionictim ha% ineFecti$e

co(gh

ictim i% (na'e to %pea+or 'reath

ictim i% di%paying theUni$er%a Sign

for cho+ing

Prepare to hep $ictim

Abdominal Thrust



• an emergen!y ro!edure forremo0ing a foreign ob=e!t lodgedin the air3ay that is re0enting a

erson from breathing

• ,ote : A: sould not be usedin!ants under + year o! age due tote risk o! causing injury$

Management of 7oreign 9odyAir,ay O'%tr(ction%



Air,ay O'%tr(ction%

Air,ay o'%tr(ction in an ad(t orchid

:f the $ictim i% con%cio(%4 %tand 'ehind

them and perform a'domina thr(%t%#:f the $ictim i% o'e%e or pregnant4 %tand

'ehind them and perform che%t thr(%t%in%tead of a'domina thr(%t%#

Management of 7oreign 9odyAir,ay O'%tr(ction%



Air,ay O'%tr(ction%

:f the $ictim 'ecome% (nre%pon%i$e!

En%(re that the EMS %y%tem ha%'een acti$ated#

Perform CPR4 remem'ering to

chec+ the mo(th for foreigno')ect% 'efore each 'reath#

Step% for Managing Air,ay O'%tr(ction in aCon%cio(% Ad(t or Chid



Co %c o(% d( o C d

=# -oo+ for %ign% ofcho+ing#

"# Pace yo(r *%t,ith the th(m' %ideagain%t the patient@%a'domen4 )(%t

a'o$e the na$e#

6# Gra%p the *%t,ith yo(r otherhand and pre%% intothe a'domen ,ith

0(ic+ in,ard and(p,ard thr(%t%#

5oreign Body Air3ay *!$truction1anageent

Give 5 blowsirway clear!monitor

til h l i



Give 5 blows

Still choking

Give 5 abdominal

thrusts

Still choking

If obviously pregnant or

known to be pregnant :

give 5 chest thrusts

irway clear!monitor

until help arrives

If victim"patient becomes

unconscious# provide

intervention for unconscious

choking victim

until help arrives

Performing A'domina Thr(%t (nderSpecia Con%ideration% !




#$viously pregnant and very#$ese victi!

The main di1erence in performing

abdominal thrust on this group of people is the placement of the &sts% instead of using abdominal thrust0

chest thrust are used% the &sts are placed against the middle

of the breastbone and do chest thrust%

Ca(tion ! for pregnant and



Ca(tion ! for pregnant and

o'e%e $ictim

• if the regnant and obese

be!ome un!ons!ious call "orELP an# per"orm CP*



:nfant Cho+ing

;9irth to = year<

Recogni5e cho+ing



Q Cannot cry or ma+e norma%o(nd%

Q Sient co(gh

Q 9reathing ,ith high/pitchednoi%e%

Q May oo+ '(e4 frightened

Management



7ive 6 !ac $lap$& Hod the infant facedo,n and

%(pport the )a, and head



Management



Gi$e 6 che$t thru$t$&urn the infant

o$er ,hie %(pporting the head



Management



Aternate 6 !ac $lap$ and6 che$t thru$t$ until

Q O')ect come% o(tor Q :nfant can cry forcef(y

or Q :nfant %top% re%ponding

Management



g

:f the infant %top% re%ponding

Q 9egin %tep% of CP#

Q Each time yo( open the air,ay4 loo forthe o!/ect (reove it if $een)

Q After B cyce%4 phone EMS

Q Re%(me CPR (nti infant %tart% to mo$eor EMS re%c(er% ta+e o$er



79AO Management !Ad . Chid . : f



Ad(t . Chid . :nfant

1 >etermine s!ene safety

# Introdu!e yourself to the 0i!timguardian or bystander

; >etermine le0el of breathing diffi!ultyby !he!8ing

a. Infant : ine!!ective coug, weak orabsence o! cry

% Chil#.a#ult : by asking i! te

victim is coking$

79AO Management !Ad(t . Chid . :nfant



. .

4 2roerly osition the 0i!tim

a Infant : suort the infant on

the res!uer:s 8nee or la

b Child adult : assume

straddle osition behind

the 0i!tim

79AO Management !Ad(t . Chid . :nfant



5 o!ate roer site a Infant : gi0e 5 ba!8 slas and

5 !hest thrusts using fingers

te!hniues b Child adult for abdominal

thrust roerly osition balled

fist on the atient roerly erform abdominal thrust

79AO Management ! Ad(t . Chid .:nfant



:nfant

6 Carefully lay do3n un!ons!ious atient

Call for hel to a!ti0ate )edi!al Assistan!eDfor ediatri!s and adultsE and erformC2+

"Che!8 oral !a0ity for resen!e ofobstru!tion

- Is foreign body is 0isible

erform finger s3ee

- if not 0isible roerly administer first res!ue breathing

79AO Management ! Ad(t . Chid . :nfant



L If air boun!e ba!8 re-osition 0i!tim:s

head and roerly administer se!ond

+

1$ After # minutes if not yet done

a!ti0ate *)S11 If still un!ons!ious erform C2+ and

aly A*> if a0ailable

1# If 0i!tim be!omes !ons!ious

roerly la!ed in re!o0ery

osition



#eference$• +,+ !nternational Consensus on



+,+ !nternational Consensus onCardiopulmonary 5esuscitation and 6mergency

Cardio"ascular Care Science 7ith Treatment5ecommendations

• +,+ American 8eart Association and American5ed Cross !nternational Consensus on 2irst Aid

Science 7ith Treatment 5ecommendations• +,+ American 8eart Association 9uidelines for

Cardiopulmonary 5esuscitation and 6mergencyCardio"ascular Care

• +,+ American 8eart Association and American5ed Cross 9uidelines for 2irst Aid

Short Version Bls -Cpr 2012 (Infant&Child) Outline

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Transcript of Short Version Bls -Cpr 2012 (Infant&Child) Outline